Stage 1: early febrile or mild phase |
0–3 days |
Non-specific features: fever, weakness, lethargy, and myalgia |
Ambulatory, able to compensate for fluid losses; no indication for fluid administration |
Stage 2: gastrointestinal phase |
3–10 days |
Same as early stage plus diarrhea, vomiting, or both, or abdominal pain |
Unable to compensate for fluid losses because of emesis or large volume losses; frequent indication for intravenous fluid administration |
Stage 3: complications phase |
7–12 days |
Same as gastrointestinal phase plus hemorrhage, shock, organ failure, and neurological complications |
Critically ill, often with multisystem organ dysfunction such as acute kidney injury, coagulopathy, hemorrhage, encephalopathy, altered mental status, seizures |